- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $25.70 / $29.51
| Professional | | $12.02 | $25.70 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $3.02 / $4.47 / $12.30
| Professional | 26 | $3.02 | $4.47 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $7.94 / $19.95 / $25.70
| Professional | TC | $7.94 | $19.95 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $10.00 / $10.00
| Professional | | $10.00 | $10.00 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.14 / $2.57 / $12.59
| Professional | 26 | $2.14 | $2.57 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $11.22 / $15.14
| Professional | | $8.32 | $11.22 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $1.86 / $2.19 / $9.77
| Professional | 26 | $1.86 | $2.19 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $6.17 / $9.55 / $9.55
| Professional | TC | $6.17 | $9.55 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $10.96 / $20.42
| Facility | | $10.23 | $10.96 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.95 / $3.16 / $5.89
| Facility | 26 | $2.95 | $3.16 | $5.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $14.79 / $26.92
| Professional | | $7.94 | $14.79 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.09 / $2.29 / $6.61
| Professional | 26 | $2.09 | $2.29 | $6.61 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $5.62 / $12.59 / $20.42
| Professional | TC | $5.62 | $12.59 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $21.38 / $26.30
| Professional | | $3.47 | $21.38 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $1.05 / $5.62 / $6.92
| Professional | 26 | $1.05 | $5.62 | $6.92 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $2.45 / $15.49 / $19.50
| Professional | TC | $2.45 | $15.49 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $16.22 / $26.30
| Professional | | $15.14 | $16.22 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $4.07 / $4.27 / $7.24
| Professional | 26 | $4.07 | $4.27 | $7.24 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $10.96 / $12.02 / $18.62
| Professional | TC | $10.96 | $12.02 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $8.13 / $37.15
| Facility | | $2.34 | $8.13 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $14.13 / $37.15
| Professional | | $9.55 | $14.13 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.57 / $2.82 / $13.18
| Professional | 26 | $2.57 | $2.82 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $6.76 / $11.22 / $24.55
| Professional | TC | $6.76 | $11.22 | $24.55 |